HBO2 for sudden sensorineural hearing loss

2020 ◽  
pp. 271-295
Author(s):  
Tracy Leigh LeGros ◽  
Heather Murphy-Lavoie ◽  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Organ Of Corti ◽  
Abrupt Onset ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Retrospective Case ◽  
Randomized Controlled ◽  
Randomized Controlled Studies

Sudden sensorineural hearing loss (SSNHL) presents as an abrupt onset of hearing loss; 88% of these presentations are idiopathic (ISSHL). Many mechanisms of injury and etiopathologies have been postulated, but they share a common result – hypoxia of the organ of Corti leading to hair cell-cilia fusion, synaptic, dendritic swelling and sustained depolarization. Of all of the various treatments tried, only corticosteroids and hyperbaric oxygen (HBO2) therapy have shown benefit in randomized controlled trials (RCTs). This paper reviews the pathophysiology of SSNHL, the variety of treatments studied, and the best evidence (both retrospective case controlled and prospective randomized controlled studies) for the use of HBO2 and corticosteroids. The best results are obtained when these two treatments are combined and initiated within 14 days of symptom onset. HBO2 is given at 2-2.5 ATA for 90 minutes for 10-20 sessions. Steroids should be dosed at 1mg/kg/day and slowly tapered over two to three weeks. If a patient is not a good candidate for or refuses systemic steroids, good results have also been obtained using intratympanic (IT) steroids in combination with HBO2. Patients should be followed by and otolaryngologist before, during and following HBO2. For severe hearing loss treatment with HBO2 improves by 37.7 dB, 19.3dB for those with moderate loss and 15.6 dB improvement overall. These recoveries, on average, improve a patient’s hearing from ranges requiring hearing aids and sign language, to levels at which normal or near-normal hearing is restored.

scholarly journals Vestibular prognosis in idiopathic sudden sensorineural hearing loss with vestibular dysfunction treated with oral or intratympanic glucocorticoids: a protocol for randomized controlled trial

2020 ◽  
Author(s):  
Huawei Li ◽  
Weiming Hao ◽  
Liping Zhao ◽  
Huiqian Yu
Keyword(s):  
Randomized Controlled Trial ◽  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Controlled Trial ◽  
Vestibular Function ◽  
Vestibular Dysfunction ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Hearing Outcome ◽  
Randomized Controlled

Abstract Background Idiopathic sudden sensorineural hearing loss (ISSNHL) is a rapid-onset sensorineural hearing impairment with unclear etiology and unsatisfying treatment effects. Vestibular dysfunction has been considered as a poor indicator in the clinical manifestations and prognosis of ISSNHL, which occurred in approximately 28%-57% cases. Glucocorticoids, administered through oral or intratympanic way, is currently a regular and standard treatment for ISSNHL based on hearing outcome. However, little investigations have been conducted on the recovery process and treatment effects of glucocorticoids on vestibular dysfunctions of ISSNHL. This study aims to compare the efficacy of oral or intratympanic glucocorticoids in ISSNHL with vestibular dysfunction in terms of the pattern and trajectory of possible process of vestibular function recovery.Methods/Design A randomized, outcome-assessor- and analyst-blinded, controlled, clinical trial (RCT) will be carried out. A group of seventy-two patients with ISSNHL complaining of vestibular dysfunction appearing as vertigo, dizziness or imbalance will be recruited and randomized into two arms of either oral or intratympanic glucocorticoids therapy with a 1:1 allocation ratio. The primary outcomes will be vestibular function outcomes assessed by sensory organization test, caloric test, video head impulse test, and vestibular evoked myogenic potentials; the secondary outcomes include self-reported vestibular dysfunction symptoms; dizziness-related handicap, visual analogue scale for vertigo and tinnitus; and pure tone audiometry. Assessment will be performed at baseline and at 1, 2, 4, and 8 weeks post-randomization. To our knowledge, this will be the first randomized controlled trial focusing on the prognosis of vestibular dysfunction in ISSNHL and the efficacy of glucocorticoids therapy for the vestibular dysfunction in this disease.Discussion This trial will be the first RCT study focusing on the progress and prognosis of vestibular dysfunction in ISSNHL. Efficacy of two commonly used therapies of glucocorticoids will be compared in both auditory and vestibular function fields, rather than in the hearing outcome alone. Trial registration ClinicalTrials.gov, NCT03974867. Registered on July 23, 2019.

scholarly journals Early Posttreatment Audiometry Underestimates Hearing Recovery after Intratympanic Steroid Treatment of Sudden Sensorineural Hearing Loss

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Benjamin J. Wycherly ◽  
Jared J. Thompkins ◽  
H. Jeffrey Kim
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Sudden Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Speech Discrimination ◽  
Case Review ◽  
Retrospective Case ◽  
Hearing Recovery ◽  
History Of

Objective. To review our experience with intratympanic steroids (ITSs) for the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL), emphasizing the ideal time to perform follow-up audiograms.Methods. Retrospective case review of patients diagnosed with ISSNHL treated with intratympanic methylprednisolone. Injections were repeated weekly with a total of 3 injections. Improvement was defined as an improved pure-tone average ≥20 dB or speech-discrimination score ≥20%.Results. Forty patients met the inclusion criteria with a recovery rate of 45% (18/40). A significantly increased response rate was found in patients having an audiogram >5 weeks after the first dose of ITS (9/13) over those tested ≤5 weeks after the first dose of ITS (9/27) ().Conclusions. Recovery from ISSNHL after ITS injections occurs more frequently >5 weeks after initiating ITS. This may be due to the natural history of sudden hearing loss or the prolonged effect of steroid in the inner ear.

Ethics of Placebo Control in Trials for Idiopathic Sudden Sensorineural Hearing Loss

2016 ◽  
Vol 155 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Miguel Maldonado Fernández ◽  
Susan Kornetsky ◽  
Laura Rubio Rodriguez
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Placebo Control ◽  
Cochrane Systematic Review ◽  
Sudden Loss ◽  
Randomized Controlled ◽  
Systemic Corticosteroids ◽  
Loss Of Hearing

Idiopathic sudden sensorineural hearing loss (ISSHL) involves sudden loss of hearing from cochlear or retrocochlear origin of unknown cause. Systemic corticosteroids may be considered in the management of ISSNHL. However, an updated Cochrane systematic review concludes that “the value of steroids in the treatment of idiopathic sudden sensorineural hearing loss remains unclear since the evidence obtained from randomized controlled trials is contradictory in outcome.” Therefore, a new clinical trial that addresses this question is mandatory. A first step in its design is to determine if placebo control would be ethically acceptable. We conclude that there is equipoise (uncertainty) about the use of corticosteroids for ISSHL. A new trial is justified—but with the inclusion of interim analyses to detect early imbalances on efficacy or safety and with the ability to stop the trial if needed.

Welche Behandlung wirkt beim Hörsturz am besten?

2018 ◽  
Vol 97 (07) ◽  
pp. 448-449
Author(s):  
Volker Schartinger
Keyword(s):  
Randomized Controlled Trial ◽  
Hearing Loss ◽  
Combination Therapy ◽  
Sensorineural Hearing Loss ◽  
Systemic Therapy ◽  
Controlled Trial ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Randomized Controlled

Ashtiani MK at al. Efficacy of systemic and intratympanic corticosteroid combination therapy versus intratympanic or systemic therapy in patients with idiopathic sudden sensorineural hearing loss: a randomized controlled trial. Eur Arch Otorhinolaryngol 2018; 275: 89–7 Iranische HNO-Ärzte verglichen die Heilungsraten einer Behandlung des idiopathischen Hörsturzes mit oralen und intratympanalen Kortikosteroidgaben in Mono- und Kombinationstherapien.

Motivational Interviewing as an Adjunct to Hearing Rehabilitation for Patients with Tinnitus: A Randomized Controlled Pilot Trial

2016 ◽  
Vol 27 (08) ◽  
pp. 669-676 ◽  
Author(s):  
Reza Zarenoe ◽  
Lena Lindhe Söderlund ◽  
Gerhard Andersson ◽  
Torbjörn Ledin
Keyword(s):  
Hearing Loss ◽  
Motivational Interviewing ◽  
Sensorineural Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Pilot Trial ◽  
Sensorineural Hearing ◽  
Future Research ◽  
Hearing Rehabilitation ◽  
Randomized Controlled

Purpose: To test the effects of a brief motivational interviewing (MI) program as an adjunct to hearing aid rehabilitation for patients with tinnitus and sensorineural hearing loss. Research Design: This was a pilot randomized controlled trial. Study Sample: The sample consisted of 50 patients aged between 40 and 82 yr with both tinnitus and sensorineural hearing loss and a pure-tone average (0.5, 1, 2, and 4 kHz) < 70 dB HL. All patients were first-time hearing aid users. Intervention: A brief MI program was used during hearing aid fitting in 25 patients, whereas the remainder received standard practice (SP), with conventional hearing rehabilitation. Data Collection and Analysis: A total of 46 patients (N = 23 + 23) with tinnitus were included for further analysis. The Tinnitus Handicap Inventory (THI) and the International Outcome Inventory for Hearing Aids (IOI-HA) were administered before and after rehabilitation. THI was used to investigate changes in tinnitus annoyance, and the IOI-HA was used to determine the effect of hearing aid treatment. Results: Self-reported tinnitus disability (THI) decreased significantly in the MI group (p < 0.001) and in the SP group (p < 0.006). However, there was greater improvement in the MI group (p < 0.013). Furthermore, the findings showed a significant improvement in patients’ satisfaction concerning the hearing aids (IOI-HA, within both groups; MI group, p < 0.038; and SP group, p < 0.026), with no difference between the groups (p < 0.99). Conclusion: Tinnitus handicap scores decrease to a greater extent following brief MI than following SP. Future research on the value of incorporating MI into audiological rehabilitation using randomized controlled designs is required.

Hyperbaric oxygen therapy for idiopathic sudden sensorineural hearing loss and tinnitus: a systematic review of randomized controlled trials

2005 ◽  
Vol 119 (10) ◽  
pp. 791-798 ◽  
Author(s):  
M Bennett ◽  
T Kertesz ◽  
P Yeung
Keyword(s):  
Hearing Loss ◽  
Randomized Controlled Trials ◽  
Sensorineural Hearing Loss ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Controlled Trials ◽  
Randomized Controlled

Background: Idiopathic sudden sensorineural hearing loss (ISSHL) and tinnitus are common. Hyperbaric oxygen therapy (HBOT) may improve hearing loss and/or reduce the intensity of tinnitus.Methods: We performed a systematic search of the literature for randomized controlled trials, and made pooled analyses of pre-determined clinical outcomes where possible.Results: Six trials contributed to this review (304 subjects). Pooled analysis suggested a significantly increased chance of a 25 per cent improvement in hearing threshold on pure tone average with HBOT (relative risk (RR) 1.39, 95 per cent confidence interval (CI) 1.05–1.84, p = 0.02; number-needed-to-treat 5, 95 per cent CI 3–20), but not a 50 per cent increase (RR 1.53, 95 per cent CI 0.85–2.78, p = 0.16). The significance of any improvement in tinnitus following HBOT could not be assessed due to poor reporting.Conclusions: HBOT improved hearing, but the clinical significance of the level of improvement is not clear. Routine application of HBOT to patients with ISSHL is not justified by this review. More research is needed.

Sign in / Sign up

Export Citation Format

Share Document